Jennifer A Mutters, PHARMD
Individual provider Active NPI Pharmacist · Anderson, OH
NPI 1104112952 · NPPES record last updated Jun 21, 2011
Key facts
- NPI
- 1104112952
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03223726 (OH)
- Practice address
- 8680 Beechmont Ave
T-1092
Anderson, OH 45255-4710 - Phone
- (513) 474-6367
- Fax
- (513) 474-6367
- NPI assigned
- Jun 21, 2011
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03223726 | OH | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03223726 | OH | Yes |
Addresses
Primary practice location
8680 Beechmont Ave
T-1092
Anderson, OH 45255-4710
Mailing address
8680 Beechmont Ave
T-1092
Anderson, OH 45255-4710
Phone (513) 474-6367
Other providers in Anderson, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.